Fecal Carriage of Extended-Spectrum Beta-Lactamasesproducing Escherichia Coli in Hospitals and Community Settings: A Review

Abstract

Antibiotic resistance is an emerging threat worldwide, endangering the treatment of serious diseases. Widespread resistance to beta-lactam antibiotics among Gram-negative bacteria (GNB) is a serious threat to the currently used antibacterial therapy. Extended-spectrum beta-lactamases (ESBLs) are a group of enzymes capable of hydrolyzing extended-spectrum cephalosporins and are inhibited by clavulanic acid. These enzymes are a major cause of hospital-acquired infection and community-acquired infections caused by E. coli (Escherichia coli). E. coli forms a part of normal intestinal flora and is an important reservoir of the antibiotic-resistant genes for ESBLs. These resistant antibiotic genes can be easily spread among GNB as these are carried on plasmids. Fecal carriers of ESBL producing E. coli in hospitalized patients and in community can be a reservoir for person-to-person transmission strengthening their dissemination. Over the last few decades, there had been a considerable increase in the emergence and spread of antimicrobial-resistant enzymes favoring the predominance of antibiotic-resistant bacteria which results in morbidity, mortality, and increased hospital expenditure. The gastrointestinal tract plays an important role in development of antibiotic-resistant microorganism and harboring the microorganisms as commensal. Antibiotic consumption may lead to alteration in the genome of the microorganisms leading to emergence of resistant microorganisms. The resistant microorganisms may then spread into the environment through faces aiding dissemination of the resistant genes.